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Obesity and Heart Attacks

According to the Center of Disease and Prevention (CDC), 35% of American adults are obese with an additional 33.3% overweight. Also, according to the American Heart Association, in 2008, one in nine death certificates (281,437 deaths) in the United States cited deaths related to heart failure. Most people are aware that there is some correlation between obesity and heart attacks, an assumption backed by various studies.

Many researchers have noted that obesity may lead to heart attacks via several different paths, such as diabetes or sleep apnea. One common path is the thickening of artery walls (atherosclerosis). In fact, even this thickening process is caused by many different factors, one of the most familiar of which is cholesterol intake. Many people are aware that there is “good” cholesterol and “bad” cholesterol. Bad cholesterol (LDL/ Low-density lipoprotein) deposits cholesterol in the artery wall; however, good cholesterol (HDL/ High-density lipoprotein) removes cholesterol from plaques and from the bloodstream.

In other words, more bad cholesterol will make artery walls thicker and more good cholesterol will make artery walls thinner.

Most obese people tend to have low HDL and high LDL levels due to personal habits. Lack of exercise and consumption of trans fat are two main factors that raise LDL levels and lower HDL levels. Also, excess visceral (abdominal) fat leads to thickening of artery walls, and also leads to insulin resistance. Ultimately, increased insulin resistance can turn to diabetes which itself accelerates the atherosclerosis process by several different mechanisms such as increased blood sugar levels.

Many obese people resort to bariatric (weight loss) surgery, such as reduction of the size of the stomach, in order to avoid obesity related health problems such as heart attacks. Another well-known bariatric surgery is the adjustable gastric band, also known as the lap-band. Unfortunately, as effective in weight loss as such surgery is, bariatric surgery involves great risks, as all major surgeries do. As a result, it is only recommended for only highly obese people. In fact, avoiding obesity and watching one’s BMI (Body Mass Index) and cholesterol level in the first place through diet and exercise is always preferable to surgery, which is not only safer but likely more cost effective.

Of course, advising people to avoid obesity is easier said than done. But the alternative of heart disease related death or death due to surgical complications is obviously not an “easy” life choice either.

Hyunho Jeon